FDA Adverse Event Other Summary report: N

SMARTPLUG

MDR report key: 557022 · Received April 30, 2004

Report

Report Number
2031959-2004-00010
Event Type
Other
Date Received
April 30, 2004
Report Date
April 29, 2004
Manufacturer
MEDENNIUM, INC.
Product Code
LZU
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
IL, US
Reporter Occupation
PHYSICIAN

Narratives

Description of Event or Problem · 1

THE FOLLOWING STATEMENT WAS DOCUMENTED IN MEDENNIUM'S CONTACT US CONTROLLED FORM, UNDER THE PRODUCT EXPERIENCE REPORT SECTION, BY MEDENNIUM FOR DR. "THE DOCTOR REPORTED THAT SHE IMPLANTED THE SMARTPLUG IN THE LOWER PUNCTA OF A MIDDLE AGE PT WITH SEVERE DRY EYE. THE PT CAME BACK TWO WEEKS LATER WITH SIGNS OF INFECTION (DISCHARGE, REDNESS, AND PAIN) IN ONE EYE. THE DOCTOR FLUSHED THE PLUG OUT AND GAVE THE PT ORAL ANTIBIOTIC. FOUR WEEKS LATER THE SECOND EYE HAD A SIMILAR REACTION TO THE SMARTPLUG AND THE DOCTOR PERFORMED THE SAME PROCEDURE. AFTER A MONTH THE PT WAS DOING FINE. MEDENNIUM ASKED THE DOCTOR IF SHE WAS SURE ON THE INFECTION. THE DOCTOR WAS NOT SURE."

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SMARTPLUG PUNCTUM PLUG LZU MEDENNIUM, INC. MODEL 500 UNK

Patients

Seq Age Sex Outcome Treatment
1 UNKNOWN Other